Share This Article:

The Pectoralis Major Myocutaneous Pedicled Flap Revisited

Abstract Full-Text HTML Download Download as PDF (Size:367KB) PP. 380-384
DOI: 10.4236/ss.2013.49075    4,979 Downloads   6,530 Views   Citations

ABSTRACT

The pectoralis major myocutaneous pedicle flap (PMMF) is still being used by many surgeons and plays an important role in head and neck reconstruction. The purpose of this series was to review our 10 years’ experience with the PMMF in head and neck reconstruction. One hundred and two patients who underwent the PMMF technique were reviewed on the clinical records. Postoperative complications were classified into flap loss, hemorrhage, infection, fistula formation, wound dehiscence and donor site complication. Eighty two patients (80.4%) demonstrated no complication. Six patients among 102 patients (5.9%) demonstrated total or partial skin necroses. Three female patients were completely dissatisfied with the cosmetic appearance after the PMMF. One of them required a reconstructive surgery with the latissimusdorsi flap. Without surgical expertise in plastic surgical field, an ear-nose-throat or an oral surgeon can performed the PMMF technique provided the operator is well aware of serious and frequent complications of this “workhorse” procedure.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

S. Asamura, H. Kakizaki, K. Mori, K. Matsunaga, W. Mitsuhiro and N. Isogai, "The Pectoralis Major Myocutaneous Pedicled Flap Revisited," Surgical Science, Vol. 4 No. 9, 2013, pp. 380-384. doi: 10.4236/ss.2013.49075.

References

[1] S. Ariyan, “Further Experiences with the Pectoralis Major Myocutaneous Flap for the Immediate Repair of Defects from Excisions of Head and Neck Cancers,” Plastic and Reconstructive Surgery, Vol. 64, No. 5, 1979, pp. 605-612.
[2] V. R. Ramakrishnam, W. Yao and J. P. Campana, “Improved Skin Paddle Survival in Pectoralis Major Myocutaneous Flap Reconstruction of Head and Neck Defects,” Archives of Facial Plastic Surgery, Vol. 11, No. 5, 2009, pp. 306-310. doi:10.1001/archfacial.2009.67
[3] K. Kiyokawa, Y. Tai, H. Y. Tanabe, et al., “A Method That Preserves Circulation during Preparation of the Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction,” Plastic and Reconstructive Surgery, Vol. 102, No. 3, 1998, pp. 2336-2345. doi:10.1097/00006534-199812000-00010
[4] M. L. Castelli, G. Pecorari, G. Succo, et al., “Pectoralis Major Myocutaneous Flap,” European Archives of OtoRhino-Laryngology, Vol. 258, No. 10, 2001, pp. 542-545. doi:10.1007/s004050100389
[5] R. A. Dedivitis and A. V. Guimaraes, “Pectoralis Major Myocutaneous Flap in Head and Neck Cancer Reconstruction,” World Journal of Surgery, Vol. 26, No. 1, 2002, pp. 67-71. doi:10.1007/s00268-001-0183-4
[6] J. P. Shah, V. Haribhakti, T. R. Loree, et al., “Complications of the Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction,” The American Journal of Surgery, Vol. 160, No. 4, 1990, pp. 352-355. doi:10.1016/S0002-9610(05)80541-0
[7] S. S. Kroll, H. Goepfert, M. Jones, et al., “Analysis of Complications in 168 Pectoralis Major Myocutaneous Flaps Used for Head and Neck Reconstruction,” Annals of Plastic Surgery, Vol. 25, No. 2, 1990, pp. 93-97. doi:10.1097/00000637-199008000-00003
[8] R. Liu, P. Gullane, D. Brown, et al., “Pectoralis Major Myocutaneouspedicled Flap in Head and Neck Reconstruction: Retrospective Review of Indications and Results in 244 Consecutive Cases at the Toronto General Hospital,” The Journal of Otolaryngology, Vol. 30, No. 1, 2001, pp. 34-40. doi:10.2310/7070.2001.21011
[9] A. Milenovic, M. Virag, V. Uglesic, et al., “The Pectoralis Major Flap in Head and Neck Reconstruction: First 500 Patients,” Journal of Cranio-Maxillofacial Surgery, Vol. 34, No. 6, 2006, pp. 340-343. doi:10.1016/j.jcms.2006.04.001
[10] J. N. Mclean, G. W. Carlson and A. Losken, “The Pectoralis Major Myocutaneous Flap Revisited. A Reliable Technique for Head and Neck Reconstruction,” Annals of Plastic Surgery, Vol. 64, No. 5, 2010, pp. 570-573.
[11] J. G. Vartanian, A. L. Carvalho, S. M. Carvalho, et al., “Pectoralis Major and Other Myofascial/Myocutaneous Flaps in Head and Neck Cancer Reconstruction: Experience with 437 Cases at a Single Institution,” Head Neck, Vol. 26, No. 12, 2004, pp. 1018-1023. doi:10.1002/hed.20101
[12] D. S. Schneider, V. Wu, et al., “Indications for Pedicledpectoralis Major Flap in a Free Tissue Transfer Practice,” Head Neck, Vol. 34, No. 8, 2012, pp. 1106-1110.
[13] K. Matsunaga, K. Mori, S. Asamura, et al., “Swallowing Function in Patients Who Underwent Hemiglossectomy and Reconstruction with a Pectoralis Major Myocutaneous Flap,” Journal of Japanese College of Surgeons, Vol. 33, No. 6, 2008, pp. 829-836.
[14] K. Matsunaga, K. Kawanishi, N. Iosgai, et al., “Serial Changes in Swallowing Function in a Case of Dysphagia after Jejunal Reconstruction of the Cervical Esophagus: A Case Report,” Esophagus, Vol. 4, No. 1, 2007, pp. 47-51. doi:10.1007/s10388-006-0105-5
[15] H. Rikimaru, K. Kiyokawa, K. Watanabe, et al., “New Method of Preparing a Pectoralis Major Myocutaneous Flap with a Skin Paddle That Includes the Third Intercostal Perforating Branch of the Internal,” Plastic and Reconstructive Surgery, Vol. 123, No. 4, 2009, pp. 1220-1228. doi:10.1097/PRS. 0b013e31819f2967
[16] S. S. Kroll, G. R. Evans, D. Goldberg, et al., “A Comparison of Resource Costs for Head and Neck Reconstruction with Free and Pectoralis Major Flaps,” Plastic and Reconstructive Surgery, Vol. 99, No. 5, 1997, pp. 1282-1286.
[17] H. Rikimaru, K. Kiyokawa, Y. Inoue, et al., “Three-Dimensional Anatomical Vascular Distribution in the Pectoralis Major Myocutaneous Flap,” Plastic and Reconstructive Surgery, Vol. 115, No. 5, 2005, pp. 1342-1352. doi:10.1097/01.PRS.0000156972.66044.5C
[18] Y. Ide, “Anatomical Study of the Vascular Distribution in the Pectoralis Major and Its Surrounding Tissue—Especially of the Pectoral Branch of the Thoracoacromial Artery,” Archives of Oral Biology, Vol. 37, No. 4, 1995, pp. 255-275. doi:10.2330/joralbiosci1965.37.255
[19] C. J. Kerawala, J. Sun, Z. Y. Zhang, et al., “The Pectoralis Major Myocutaneous Flap: Is the Subclavicular Route Safe?” Head Neck, Vol. 23, No. 10, 2001, pp. 879-884. doi:10.1002/hed.1127
[20] W. I. Wei, K. H. Lam and J. Wong, “The True Pectoralis Major Myocutaneous Island Flap: An Anatomical Study,” British Journal of Plastic Surgery, Vol. 37, No. 4, 1984, pp. 568-573. doi:10.1016/0007-1226(84)90151-6
[21] J. H. Palmer and A. G. Batchelor, “The Functional Pectoralis Major Musculocutaneous Island Flap in Head and Neck Reconstruction,” Plastic and Reconstructive Surgery, Vol. 85, No. 3, 1990, pp. 363-367. doi:10.1097/00006534-199003000-00004

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.